Reasonable Training And Policy Direction On Handling Of The Mentally Ill And Emotionally Disturbed Persons?

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In Walker v. City of New York, the United States Court of Appeals for the 2nd Circuit gave law enforcement some direction for determining what training officers must be provided with to do their jobs professionally and with lower liability exposure. Essentially the case indicated that if you know to a moral certainty that officers will confront a certain situation; and that encounter will force officers to make a choice between different alternatives; and making the wrong choice will expose persons to potential Constitutional violations; then the agency must provide these officers with reasonable training to equip them to make these difficult and critical choices. This is simply a further explanation of United States Supreme Court case on training, City of Canton v. Harris.
Every police agency should know that this is the case with officers encountering mentally ill persons and others who are emotionally disturbed or of diminished capacity. Of course, field officers are not expected to make a diagnosis of these types of clinical problems. These officers, however, are expected to recognize that the persons they are confronting are engaged in unusual, bizarre and/or abnormal behavior and require field tactics to control the situation that are different than those used during a confrontation with a criminal. At the same time officers know that these persons are engaging in behavior that jeopardize themselves and/or others including the officers who are responding to the crisis brought on by this abnormal, bizarre, erratic personal conduct whether it’s the product of a mental illness, suicidal tendency, substance abuse, alcoholism or other personal crisis. Some evidence of this policing problem:

Public beds for the mentally ill have continuously been decreasing since the administration of President Kennedy

Emotionally disturbed/mentally ill persons are 5.5 times more likely to be the subjects involved in the murder of police officers

The Los Angeles County Sheriff’s jail facilities are considered to be the largest confinement of mentally ill persons in the country

The Bureau of Justice Administration believed that 16 percent of the persons in U.S. jails are mentally ill and that 75 percent of those have substance abuse problems (San Francisco Chronicle 1-23-06)

The population of homeless persons, principally in urban areas, has steadily increased and it is commonly referenced that the mentally ill and persons with substance abuse problems exceeds half of the homeless population

The result of these societal and community indicators is simply that law enforcement must provide its field officers with the essential training and tools to deal with these types of persons in a manner to minimize the potential of injury to all involved. But is law enforcement providing these officers with these necessary tools? Take a look at police basic training programs throughout the country. Most still are providing only 4 or 6 hours of specific academy training consisting of a recitation of clinical mental illnesses and the procedures and documents necessary for an involuntary commitment. Other aspects of handling these types of encounters might be in other segments of the basic training program, but specific references might be difficult to locate as they normally are embedded in patrol tactics, defensive tactics or field scenarios.

Will this level of training help a new officer who is confronting a knife wielding homeless person ranting about an unknown oppressor invading his brain or a naked, sweating male on the street at 7 in the morning digging his fingernails into his chest trying to mine the bugs invading his body? Probably not! So what would be reasonable training and policy direction to help this young officer?

What is disconcerting is the fact that law enforcement has been aware for a long time of the specific problems for dealing with these special populations as well as reasonable field tactics for confronting and handling incidents involving this group. Back in 1955 law enforcement used a film strip (not many law enforcement personnel today would even know what that means) and a manual for police handling of “abnormal people” written by Rowland and Matthews. The IACP had reasonable training bulletins issued on this topic in the 1970s.

Gerald Murphy, in his reports for the Police Executive Research Forum on police handling of the emotionally disturbed or special populations, in the mid and late 1980s, detailed a recommended training program of 16 hours. During that same period as an example, the Oklahoma City Sheriff’s Office, responsible for mental health pickups, provided its designated unit with 24 hours of training in tactics and procedures for dealing with these types of special populations.

In the late 1980s, the Memphis Police Department created its Crisis Intervention Team (CIT) concept. It involved a 40 hour training program for selected officers. The program was presented by a blend of professionals involved with the mentally ill community and police experts in verbalization, confrontational diffusing techniques, and subject control and restraint techniques. It has not eliminated all adverse consequences in the Memphis police encounters with emotionally disturbed persons, but the agency believes it has significantly decreased this outcome.

The Cincinnati Police Department’s Consent Decree with the U.S. Department of Justice in 2003 mandated that the agency provide at least one police unit on a 24/7 deployment whose officers were trained in a program similar to the Memphis CIT curriculum and length of training. Cincinnati appears to have taken the Memphis Plan to a higher level.

If this is not sufficient motivation for a law enforcement agency to take immediate action in reevaluating the length and content of the training provided to its field officers in dealing with this special population, consider recent case decisions involving police encounters with these types of persons which have resulted in deaths. These cases appear to be a recent change in how courts are viewing officers’ use of force when dealing with obvious emotionally disturbed persons. A common term finding its way into these recent court decisions is “persons of diminished capacity.”

Marsall v. City of Portland: This case involved a call for service concerning a fight between persons in an apartment and one subject was identified as having consumed mushrooms. When the officers arrived on the scene, this subject jumped out of a second story window. During the control of the subject involving 7 officers, the subject was struck with 10 beanbag rounds, sprayed with six cans of OC, placed in maximal restraints and 2 officers stood on his upper body and head area. The subject died. The court noted that there was “no strong governmental interests…offense was minor…risk to officers and the public was low…risk of flight was also low…” Note how this decision tracks the specific language in Graham v. Conner. The court further stated, “The problems posed by, and thus the tactics…against, an unarmed, emotionally distraught individual who is creating a disturbance or resisting arrest are ordinarily different from those…(of an)armed and dangerous criminal who has recently committed a serious offense…”

Champion v. Outlook Nashville, Inc.: This case involved a 32 year old autistic motorist who was “unresponsive…unable to speak” during his detention by officers. The court noted that “No reasonable officer would have continued to spray a chemical agent in the face of a handcuffed and hobbled mentally retarded (subject)…(who was) moving his…head…to breathe,…vomited several times. No reasonable officer would continue to put pressure on…back after…subdued by handcuffs, an ankle restraint, and a police officer holding…legs” when “…they knew (the subject) to be mentally ill or retarded.”

A third representative case is Cruz v. City of Laramie. This involved a radio call concerning a naked male on the street at 7 in the morning. When the officers arrived they noted that the male was sweating profusely and digging into his skin to get rid of the “bugs.” Following his restraint, the officers immediately called for EMTs, but the subject later died. The court noted, “We do not reach the question whether all hog-tie restraints constitute a constitutional violation per se, but hold that officers may not apply this technique when an individual’s diminished capacity is apparent.”

A third representative case is Cruz v. City of Laramie. This involved a radio call concerning a naked male on the street at 7 in the morning. When the officers arrived they noted that the male was sweating profusely and digging into his skin to get rid of the “bugs.” Following his restraint, the officers immediately called for EMTs, but the subject later died. The court noted, “We do not reach the question whether all hog-tie restraints constitute a constitutional violation per se, but hold that officers may not apply this technique when an individual’s diminished capacity is apparent.”

The most reasonable approach your agency can take to develop an enhanced training program for dealing with this special population is to enter into a partnership with your local mental health profession. In Ohio, it has been found to be successful to involve these professional resource persons in a focused Citizen Police Academy to orient them to the police side of the problem. This same collaborative program involves police officers shadowing mental health professionals during their work with their consumers (a term preferred by the mental health profession). Together this combined resource group has developed a practical 40 hour training program oriented to the specific needs of the field officers. It appears to be similar to the Memphis CIT program, but somewhat more current. (T. Victor Lloyd, Mental Health Association of Southwestern Ohio)

Action steps necessary to ensure that your officers are being given the necessary training in handling this special population, are provided with the specific references required to assist them in this specific police task, and the development of increased risk management elements for your agency:

1. Conduct an assessment of what training your officers are receiving from the Academy, in-service training or specialized program offerings and delve further into areas that may contain elements of this training that may not be titled specifically on the subject;

2. Ensure that your training includes realistic scenario segments involving elements of diffusing tactics (elements of containment, coordination of resources and command, communication strategies, and elongation of the time of the encounter) for encounters with this special population;

3. Create a partnership with your local mental health professionals to develop a program that will incorporate the essential elements of the newest, expanded police training for this critical task;

4. Ensure that your written guidelines (manual, orders and/or procedures) are up-to-date and include the essential elements of handling by field officers of this special population with emphasis on diffusing field tactics; and

5. Develop a reporting format that will capture data on field encounters involving this special population. (This could become very important should your agency end up with a fatal or serious injury encounter involving a member of this special population. This type of documentation would show that your officers normally handle these types of incidents successfully without injury.)

Unfortunately, not all encounters with emotionally disturbed, mentally ill persons will end peacefully with the consumer being given the professional treatment necessary for his/her special needs. But, most of the time they will. The tactical approach of the officers can assist in bringing these critical tasks to a successful conclusion. In those rare instances when they don’t, these steps may enhance the liability protection for your employees, agency and community.